Provider Demographics
NPI:1952601189
Name:MCPHERSON COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:MCPHERSON COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CAP, CMHP
Authorized Official - Phone:904-548-0160
Mailing Address - Street 1:850310 US HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-9036
Mailing Address - Country:US
Mailing Address - Phone:904-548-0160
Mailing Address - Fax:904-548-0158
Practice Address - Street 1:850310 US HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-9036
Practice Address - Country:US
Practice Address - Phone:904-548-0160
Practice Address - Fax:904-548-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0445AD146701101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty